A pulmonary venous indentation on the esophagus-a normal variant

An extrinsic indentation on the anterior left wall of the esophagus, about 4-5 cm below the carina, is a relatively common finding and should be considered a normal variant, although rarely it may be due to an aberrant insertion of a pulmonary vein into the left atrium. The indentation is best seen in a steep left posterior oblique horizontal position. In most cases it is caused by pressure of the left inferior pulmonary vein or a common confluence of the left pulmonary veins near the insertion into the left atrium. Generally, it does not cause any symptoms and should not be mistaken for a mediastinal mass.